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,e BUSINESS CERTIFICATE# <br /> TFFE CONIA11ONIVEALTI/OF NlAS'SACFIUSETT.S P - <br /> TOW.iV OF AIIASHPEE <br /> t DATE o <br /> 0 <br /> Expiration Date: 0 <br /> r <br /> In conformity with the provisions of Chapter one hundred and ten, Section five of the General Laws, as amended, the <br /> undersigned hereby declare(s) thata.business under the title of <br /> D2uL VdE1/Ltn DBA �4'pc IS is conducted at <br /> Business Location: S0 Lll14- cepc �Gtc e- Ejt7_IS (6MC 2 I III R4 14ilon7 ✓II/4sj <br /> Business Mailing Address: 'K2d M(4 IA+s '- (-011/t7 n911• o Z a <br /> Business Type: ch01Nt n,S ge1Zt Leie Business Telephone:— (I Cl- 1 3\{o <br /> Elome Phone: '�Og— L1? 0 I?u/D G2 ��I_ of 3-6- 4x/9 3' <br /> by the following named persons: <br /> FULL NAME t RESIDENCE <br /> �m' AN /�y/� 8zo Mash St- Co�riif �-w ouo3S- <br /> I certify under the penalties of perjury that I, to the best of my knowledge and belief, have filed all state tax returns and paid all state <br /> We as required under law. e <br /> '*Signattue of authorized agent *Signature of authorized went <br /> OaS _�& 8613 <br /> **Social Security Number(Voluntary) <br /> or Federal Identification Number <br /> In case of emergency <br /> NAME: Sle,e, Ur,)((w TELEPHONE r t ER: ��-776 660 <br /> Alarm Company: <br /> '"This license will not be issued unless this certification is signed by applicant <br /> **four social security number will be furnished to the Massachusetts Department of Revenue to determine whether you have met tax filing or tax <br /> payment obligations. Licensees who fail to correct their non-filing or delinquency will be subject to license suspension or revocation. This request <br /> is made under the authority of Massachusetts General Law,Chapter 62C,Section 49A. <br /> The Commonwealth of dlassachuserts <br /> BARNSTABLE ss () V DATE <br /> Personally appeared before me the above-named Lu AR r 14. Ole L/`7• and made oath that the foregoing statement is <br /> true. <br /> A certificate issued in accordance with this section shall be in force and effect for four years from the date of issue and shall be renewed <br /> each four years thereafter so long as such business , all be conducted and shall lapse and be void unless so renewed. <br /> Signed C6 y e /z <br /> !11J\e12 <br /> DJ <br /> DEBORAH A.POOLE Notary Public <br /> SEAL Notary Public <br /> 1WCommonwealth of Massachusetts ,3 A& 1 <br /> I Commission Expires March 26,2015 mmission Expires: <br />